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Single Embryo Transfer in IVF to Prevent Multiple Pregnancies

Published online by Cambridge University Press:  21 February 2012

James Catt*
Affiliation:
Sydney IVF, Australia. [email protected]
Tina Wood
Affiliation:
Sydney IVF, Australia.
Michael Henman
Affiliation:
Sydney IVF, Australia.
Robert Jansen
Affiliation:
Sydney IVF, Australia.
*
*Address for correspondence: James Catt, Sydney IVF, GPO Box 4384 NSW 2001, Australia.

Abstract

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As the success rates of IVF clinics improve, one of the adverse consequences is the increased incidence of twins, due largely to the number of embryos transferred. Even if the number of embryos transferred is restricted to two, the twinning rate can exceed 40% of the pregnancies. An obvious way to reduce this high twin rate would be to transfer only one embryo. This would require that cryopreservation of the supernumerary embryos be efficacious enough so that the chance of achieving an ongoing pregnancy is not diminished by transferring a single embryo in the stimulated cycle. Previous studies utilising embryos on day 2 and 3 of development have shown that the pregnancy rates can be acceptable (about 40%) and that the cumulative rate can be up to 60%. Most of these studies, however, do not include a comparison with the cumulative pregnancy rate with two embryos transferred in the stimulated cycle. Therefore, the efficacy has not been proven. We present clinical data from the past few years to illustrate the increase in success rates and the concomitant increase in twinning rates. The increased success in the cryopreservation program has enabled us to trial a single embryo transfer program and compare the results to the transfer of two embryos. The results strongly suggest that the transfer of a single embryo is the better clinical option.

Type
Guest Editorial
Copyright
Copyright © Cambridge University Press 2003